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issues in oncology

Patient Expectations of Benefit in Early-phase Trials: Ethics Issues in Informed Consent 

It has been found that many patients in early-phase oncology trials believe their chance of benefit to be much higher than estimates derived from historical data.1-3 In a recently reported study in Journal of Clinical Oncology, Kevin P. Weinfurt, PhD, of Duke Clinical Research Institute, and...

leukemia

Ponatinib in Chronic Myeloid Leukemia and Philadelphia Chromosome–positive Acute Lymphoblastic Leukemia 

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On December 14, 2012, ponatinib (Iclusig) was granted...

breast cancer

Subcutaneous Trastuzumab a Potential Alternative to Intravenous Administration in Breast Cancer 

Subcutaneous administration of trastuzumab might offer improvements in patient convenience and resource use compared with conventional intravenous administration (Herceptin). A new subcutaneous trastuzumab formulation containing a fixed dose of 600 mg and recombinant human hyaluronidase PH-20...

prostate cancer

Abiraterone in Patients with Metastatic Castration-resistant Prostate Cancer and No Prior Chemotherapy

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On December 10, 2012, abiraterone acetate (Zytiga)...

prostate cancer

Abiraterone Benefits Patients with Metastatic Prostate Cancer Who Have Had No Previous Chemotherapy 

The androgen biosynthesis inhibitor abiraterone acetate (Zytiga) has been shown to increase radiographic progression-free survival and delay clinical decline and initiation of chemotherapy in a clinical trial in castration-resistant patients with metastatic prostate cancer who have had no prior...

Expert Point of View: Sarah B. Goldberg, MD, MPH

In a commentary accompanying reporting of the phase II study of the MEK inhibitor selumetinib by Dr. Pasi A. Jänne, MD, PhD, and colleagues, Sarah B. Goldberg, MD, MPH, Assistant Professor of Medicine, and colleagues at Yale Cancer Center, New Haven, Connecticut, noted that KRAS, a member of the...

lung cancer

Selumetinib/Docetaxel Shows Promising Activity in Previously Treated KRAS-mutant Non-Small Cell Lung Cancer

Currently, there are no approved therapies for KRAS-mutant non–small cell lung cancer (NSCLC), and few clinical trials have been performed specifically in this setting. In a recent article in Lancet Oncology, Pasi A. Jänne, MD, PhD, Scientific Director, Belfer Institute for Applied Cancer Science,...

colorectal cancer

Bevacizumab plus Chemotherapy after Progression of Metastatic Colorectal Cancer on First-line Therapy Including Bevacizumab 

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On January 23, 2013, bevacizumab (Avastin) was approved...

lung cancer

Use of Beta-blockers Associated with Improved Survival in Patients with NSCLC Receiving Definitive Radiation Therapy 

As reported recently in Annals of Oncology, a retrospective study by Wang and colleagues showed that use of beta-adrenergic receptor antagonists (beta-blockers), typically used in treatment of hypertension and heart disease, was associated with significantly improved distant metastasis–free...

leukemia
lymphoma
multiple myeloma

More Brief Reports from ASH, Including New Data in Leukemia, Lymphoma, and Myelodysplastic Syndrome

At the 54th Annual Meeting of the American Society of Hematology (ASH), held in Atlanta, nearly 5,000 abstracts were presented in oral sessions and posters. As part of our ongoing comprehensive coverage from the meeting, here are several more studies of note. New Targets in Acute Myeloid Leukemia...

colorectal cancer
lung cancer
prostate cancer
lymphoma
multiple myeloma
issues in oncology
palliative care

Study Shows Little Association of Multidisciplinary Tumor Boards with Measures of Care 

A survey of Veterans Affairs (VA) medical centers recently reported by Nancy L. Keating, MD, MPH, and colleagues at Harvard Medical School in the Journal of the National Cancer Institute showed that the presence of multidisciplinary tumor boards had little association with rates of recommended...

gynecologic cancers

Analysis Shows No 10-year Survival Advantage in Patients with Ovarian Cancer and BRCA1 or BRCA2 Mutations 

Several studies have suggested that short-term overall survival for women with ovarian cancer and BRCA1 or BRCA2 mutations is better than that in patients without such mutations. Indeed, a recent report by Kelly L. Bolton, PhD, and colleagues indicated that 5-year overall survival was 36% for...

breast cancer

FOXP3 Expression Linked to Better Survival with Adjuvant Anthracycline Not Followed by Taxane in Breast Cancer 

The French UNICANCER-PACS 01 trial compared six cycles of anthracycline-based adjuvant therapy with FEC (epirubicin, cyclophosphamide, fluorouracil; FEC6) vs three cycles of FEC followed by three cycles of docetaxel (FEC/docetaxel) in patients with node-positive primary breast cancer. After...

Expert Point of View: Nasser H. Hanna, MD

In an accompanying editorial, Nasser H. Hanna, MD, of Indiana University, Indianapolis, suggested that although the question of two chemotherapy drugs vs one in this setting made sense at the time GOIRC 02-2006 was initiated, advances in understanding of the heterogeneity of non–small cell lung...

lung cancer

No Benefit of Adding Carboplatin to Pemetrexed in Second-line Treatment of Patients With Advanced Non–Small Cell Lung Cancer 

An Italian randomized phase II study (GOIRC 02-2006 study) recently reported in Journal of Clinical Oncology by Andrea Ardizzoni, MD, of Azienda Ospedaliero-Universitaria in Parma, Italy, and colleagues showed no progression-free survival benefit of adding carboplatin to pemetrexed (Alimta) in...

lung cancer
palliative care

Patients Receiving Palliative Radiation Therapy for Metastatic Non–Small Cell Lung Cancer May Be Overtreated 

Many patients receiving palliative radiation therapy to the bone or chest for metastatic non–small cell lung cancer (NSCLC) may be receiving a greater number of treatments and higher doses than are supported by current evidence, according to a Cancer Care and Outcomes Research and Surveillance...

hematologic malignancies
issues in oncology

Pomalidomide in Previously Treated Multiple Myeloma 

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication On February 8, 2013, the immunomodulatory agent...

kidney cancer

Three-marker Assay for Early Detection of Renal Cancer

Early detection of renal cell carcinoma using biomarkers remains challenging. Kim and colleagues recently evaluated a three-marker assay consisting of nicotinamide N-methyltransferase (NNMT), L-plastin (LCP1), and nonmetastatic cells 1 protein (NM23A). After validation of the three-marker assay in...

colorectal cancer

Mixed-lineage Kinase 4 Interacts with Activated RAS Signaling in Colorectal Cancer

Colorectal cancer that is microsatellite stable but chromosomally unstable is characterized by poor prognosis and remains largely intractable at the metastatic stage. Mutational analysis has shown that the mixed lineage kinase 4 (MLK4) protein kinase is frequently mutated in microsatellite-stable...

pancreatic cancer

Effects of siRNA Combining TGF-β1 Silencing and RIG-I Activation in Pancreas Cancer 

Dysregulation of TGF-β signaling promotes tumor growth, invasion, metastasis, and a potent immunosuppressive network in pancreas cancer. A strategy for disrupting the tumor-promoting pathway is the silencing of TGF-β by use of small-interfering (si) RNA. Ellermeier and colleagues found that the...

solid tumors

p53 Inactivation in the Tumor Microenvironment Promotes Tumor Progression via Immunosuppressive Lymphoid-like Stromal Network

Inactivation of the tumor suppressor p53 through somatic mutations is observed in approximately half of cancers. The finding that p53 mutations sometimes occur in tumor-associated fibroblasts and are correlated with an increased rate of metastases and poor prognosis suggests that p53 dysfunction in ...

breast cancer

CDC Reports Racial Disparity in Breast Cancer Mortality  

Breast cancer deaths have declined over the past 2 decades, with approximately half of the decrease estimated to be due to advances in early detection and treatment. However, not all racial groups have benefited equally from these advances. A recent report from the Centers for Disease Control and...

breast cancer

Effects of Menarche and Menopause on Breast Cancer Risk: Meta-analysis Findings 

Menarche and menopause mark the onset and offset of ovarian and endocrine activity associated with reproduction, and early menarche and late menopause are known to increase risk of breast cancer. In a recent Lancet Oncology article, the Collaborative Group on Hormonal Factors in Breast Cancer...

leukemia

Addition of Liposomal Daunorubicin Improves Early Outcome in Patients with Pediatric Relapsed AML 

Optimal reinduction therapy for patients with relapsed pediatric acute myeloid leukemia (AML) remains undefined. Liposomal daunorubicin (DaunoXome), which offers the potential for reduced cardiotoxicity compared with traditional daunorubicin, is effective in this setting. Gertjan J.L. Kaspers, MD,...

breast cancer
integrative oncology

Qigong Practice Associated with Quality-of-life Benefits in Women Undergoing Radiation Therapy for Breast Cancer 

Qigong (“qi” or “chi” = energy flow, “gong” = skill or achievement) is an integrated mind-body exercise and meditative practice that involves rhythmic breathing coordinated with repetition of fluid movements and calm focus on the body. A study reported in Cancer by Zhen Chen, MD, and colleagues...

colorectal cancer

SIGGAR Trials Compare CT Colonography vs Barium Enema and Colonoscopy in Evaluation for Colon Cancer 

The companion UK Special Interest Group in Gastrointestinal and Abdominal Radiology (SIGGAR) trials compared computed tomographic (CT) colonography with barium enema and colonoscopy in patients with symptoms suggestive of colon cancer. As recently reported by the SIGGAR investigators in The...

breast cancer

Ado-Trastuzumab Emtansine in Metastatic Breast Cancer 

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.  Indication On February 22, 2013, ado-trastuzumab emtansine...

prostate cancer

Similar 15-year Functional Outcomes after Prostatectomy or Radiotherapy for Localized Prostate Cancer 

Comparative longer-term functional outcomes of radical prostatectomy and external-beam radiation therapy for localized prostate cancer remain undefined. In a study recently reported in The New England Journal of Medicine,1 Matthew J. Resnick, MD, and colleagues at Vanderbilt University, Nashville,...

solid tumors
colorectal cancer

More Recreational Physical Activity Associated with Reduced All-cause Mortality in Patients with Colorectal Cancer 

In a study recently reported in Journal of Clinical Oncology, Peter T. Campbell, PhD, and colleagues from the Epidemiology Research Program of the American Cancer Society, Atlanta, found that more recreational physical activity before and after a diagnosis of colorectal cancer was associated with...

solid tumors
colorectal cancer

Benefit of Continued Antiangiogenic Treatment with Bevacizumab after Progression in Metastatic Colorectal Cancer 

As reported recently in Lancet Oncology by Jaafar Bennouna, MD, of Institut de Cancérologie de l’Ouest, Nantes, France, and colleagues, the phase III ML18147 trial showed a survival benefit with continued bevacizumab (Avastin) treatment after first progression in metastatic colorectal cancer.1 The...

breast cancer

Common Deletion in APOBEC3 Genes Associated with Increased Risk of Breast Cancer 

Genome-wide association studies have identified numerous genetic susceptibility loci for breast cancer, although these loci explain only a small proportion of heritability. Relatively few studies have assessed associations of breast cancer risk with copy number variation, another important source...

lung cancer

HDAC Inhibition Circumvents EGFR Tyrosine Kinase Inhibitor Resistance Due to BIM Polymorphism 

Upregulation of BIM (BCL2L11), a proapoptotic member of the BCL2 protein family, is required for induction of apoptosis by EGFR tyrosine kinase inhibitors in EGFR-mutant forms of non–small cell lung cancer (NSCLC). A BIM deletion polymorphism occurs naturally in approximately 13% of East Asian...

breast cancer

Epithelial-to-mesenchymal Transition and Autophagy Induction in Breast Carcinoma Promote Escape from T-cell–mediated Lysis

Epithelial-to-mesenchymal transition is known to mediate cancer cell invasion, metastasis, and drug resistance, but its impact on cancer immune surveillance is less well defined. In a study reported in Cancer Research, Akalay and colleagues found that epithelial-to-mesenchymal transition and...

C-Reactive Protein Downregulates TRAIL, a Cytokine with Key Role in Cancer Immune Surveillance 

C-reactive protein is a biomarker of acute and chronic inflammation that is frequently elevated in patients with cancer. In a study reported in Clinical Cancer Research, Secchiero and colleagues found that increased levels of C-reactive protein were associated with downregulation of TRAIL, a...

multiple myeloma

Control of Autophagic Cell Death by Caspase-10 in Multiple Myeloma

Multiple myeloma subtypes are driven by a variety of genetic abnormalities. Given the genetic diversity of the disease, identification of oncogenic mechanisms common to all subtypes is highly desirable. In a study reported in Cancer Cell, Lamy and colleagues found that that all multiple myeloma...

The ASCO Post Up Close: Our Reporters and Contributors

About the Writers Charlotte Bath has been writing about cancer and related fields of medicine since serving as Public Information Director of the American Cancer Society, Long Island Division, from 1975 to 1979. She subsequently worked as a writer for Memorial Sloan-Kettering Cancer Center and...

solid tumors
pancreatic cancer
global cancer care

Oral S-1 Noninferior to Gemcitabine in Advanced Pancreatic Cancer in Japan and Taiwan 

As reported by Hideki Ueno, MD, PhD, of National Cancer Center Hospital, Tokyo, and colleagues in Journal of Clinical Oncology, treatment with the oral fluoropyrimidine derivative S-1 was associated with noninferior overall survival and reduced hematologic toxicity compared with gemcitabine...

gynecologic cancers

Women with Lynch Syndrome and Endometrial Cancer Are at Increased Risk of Other Cancers 

Lynch syndrome is an autosomal dominantly inherited disorder due to germline mutations in DNA mismatch repair genes. Mismatch repair mutation carriers are at increased risk of several cancers, with endometrial cancer being one of the most commonly diagnosed cancers in women with Lynch syndrome. In...

SIDEBAR: Mismatch Repair Genes 

Mismatch repair genes are involved in numerous cellular functions, including the recognition and correction of errors in DNA replication. Germline mutations of mismatch repair genes have been shown to be involved in various types of cancer. ■

solid tumors
colorectal cancer

12-Gene Recurrence Score Predicts Recurrence in Stage II Colon Cancer in CALGB 9851 Population 

As reported by Alan P. Venook, MD, Professor of Medicine (Hematology/Oncology) at the University of California, San Francisco, and colleagues in Journal of Clinical Oncology, a 12-gene recurrence score (Oncotype DX Colon Cancer Assay) was shown to predict recurrence in stage II colon cancer in a...

lung cancer
issues in oncology

eHealth: Caregiver Use of Online System Reduces Symptom Distress in Patients with Non–Small Cell Lung Cancer

The results of a study reported by David H. Gustafson, PhD, Research Professor at the University of Wisconsin-Madison, and colleagues in Cancer suggest that informal caregiver (eg, family member) use of a specifically designed online system to support palliative care reduces symptom distress in...

hematologic malignancies
lymphoma

Autologous Stem Cell Transplant Improves Survival in Transformed Follicular Lymphoma  

As reported by the Canadian Blood and Marrow Transplant Group in Journal of Clinical Oncology,1 patients with transformed follicular lymphoma receiving autologous transplantation have improved survival outcomes compared with patients receiving rituximab (Rituxan)-containing chemotherapy alone....

breast cancer

Risk for Ischemic Heart Disease after Radiotherapy for Breast Cancer 

A population-based case-control study reported by Sarah C. Darby, PhD, Professor of Medical Statistics in the Clinical Trial Service Unit and Epidemiologic Studies Unit at the University of Oxford, and colleagues in The New England Journal of Medicine indicates that incidental exposure of the heart ...

lung cancer

Greater Prediagnosis Soy Food Consumption Associated with Improved Survival in Women with Lung Cancer 

As recently reported by Gong Yang, MD, MPH, Research Associate Professor at Vanderbilt University School of Medicine, Nashville, and colleagues in the Journal of Clinical Oncology,1 higher prediagnosis consumption of soy food was associated with improved overall survival in Chinese women with lung...

lung cancer

New Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitor Treatment 

A new guideline for molecular testing to select lung cancer patients for treatment with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors has been jointly developed by the College of American Pathologists, International Association for the Study ...

Proof of Principle for Adoptive T-cell Therapy in Cancer 

In a recently published study, Memorial Sloan-Kettering Cancer Center investigators demonstrated the considerable antitumor efficacy of 19-28z chimeric antigen receptor (CAR)-modified T cells in patients with relapsed/refractory B-cell acute lymphoblastic leukemia (ALL). The ASCO Post asked lead...

solid tumors
leukemia

Profound and Rapid Molecular Remission with CD19-targeted T Cells in Relapsed B-cell ALL 

As was recently reported in Science Translational Medicine, Renier J. Brentjens, MD, and colleagues at Memorial Sloan-Kettering Cancer Center, New York, found that profound molecular remission was rapidly induced in patients with relapsed B-cell acute lymphoblastic leukemia (ALL) using autologous T ...

solid tumors
colorectal cancer

Smoking Linked to Shorter Disease-free Survival in Stage III Colon Cancer 

According to an analysis reported by Amanda Phipps, PhD, MPH, Assistant Professor of Epidemiology at the University of Washington and Assistant Member at Fred Hutchinson Cancer Research Center, Seattle, and colleagues in the Journal of Clinical Oncology, patients with stage III colon cancer who...

solid tumors
kidney cancer

No Difference in Overall Survival with Axitinib or Sorafenib in Second-line Treatment for Advanced Renal Cell Carcinoma 

The phase III open-label AXIS trial comparing axitinib (Inlyta) vs sorafenib (Nexavar) as second-line treatment for metastatic renal cell carcinoma showed significantly prolonged independent radiology committee–assessed progression-free survival with axitinib treatment (hazard ratio [HR] = 0.665, P ...

solid tumors
colorectal cancer
issues in oncology

Geriatric Factors Predict Severe Toxicity in Elderly Patients on First-line Treatment for Metastatic Colorectal Cancer 

Elderly patients differ with respect to tolerance of therapy for colorectal cancer. In a study reported in Journal of Clinical Oncology, Thomas Aparicio, MD, PhD, of the University of Paris, and colleagues analyzed geriatric factors for potential association with severe toxicity, dose-intensity...

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